Having assisted dental team members with thousands of coding questions, I have found that there is a lack of thorough understanding of crown repair procedure codes and their utilization. While a tooth crown can remain in service for decades, a crown may eventually need to be repaired and sometimes replaced completely.
What is dental code D2980? The code D2980 documents and reports the repair of a single natural tooth crown due to material failure. The type of restorative material makes no difference in the code nor how the crown is repaired. It is important to note the nomenclature of code D2980 was revised a few years ago to include the words “necessitated by restorative material failure”.
D2980 crown repair necessitated by restorative material failure
Scenario: Patient presents with the porcelain fractured off of a crown. Composite material was used to repair the fractured crown restoring the crown to its original function and aesthetics.
It is appropriate to document the scenario described using code D2980 because the material (porcelain) failed.
Can I use CDT code D2980 when repairing a bridge?
No. D2980 is for single crown repairs. The repair of a retainer crown or a pontic component of a fixed partial denture (FPD), commonly referred to as a bridge, is documented using D6980. As with D2980, D6980 is not indicated for the repair of an implant supported retainer crown, only a retainer crown supported by a natural tooth. Code D6980 was also revised a few years ago when D2980 was revised to specifically state “necessitated by restorative material failure”.
D6980 fixed partial denture repair necessitated by restorative material failure
Can I use CDT codes D2980 or D6980 to document & report the closure of an endodontic access hole?
No, D2980 is not appropriate for reporting closure of an endodontic access hole. Prior to the revision of D2980 and D6980, this code was used to document and report the closure of an endodontic access hole. Creating an access hole in a crown or retainer crown for the purpose of performing endodontic treatment on the tooth is not considered to be restorative material failure. It is an error to document closure of an endodontic access hole using D2980.
So, how is the closure of an endodontic access hole documented? Consider documenting and reporting this procedure using the appropriate one surface restorative code such as:
D2391 resin-based composite - one surface, anterior
D2330 resin-based composite - one surface, posterior
D2140 amalgam - one surface, primary or permanent
Insurance reimbursement - will insurance pay for crown bridge repair?
Dental plan reimbursement varies by plan design. When reporting D2980 crown repair or D6980 bridge repair, it is helpful to include a narrative describing the repair along with a pre-operative intraoral image of the crown. Including the narrative and pre operative image will increase the chances of receiving reimbursement, when the procedure is a covered service of the plan.
What you know about code D2980 -- and all codes -- helps your office get paid for everything you’ve earned. When you use the latest coding knowledge, you can generate reliable, profitable, legitimate dental insurance income for your practice.
Reading this article is a great start. Build your knowledge of codes and best practices and see your dental claims get paid faster. Learn about training programs (and CE credit) at our Dental Claims Academy.
As always, accurately document and report what you do, regardless of insurance coverage or not. Utilize radiographic and intraoral imaging to support medical necessity of the crown or bridge repair service.